Do you feel like you have heartburn after eating? Or perhaps you don’t have heartburn, but a persistent lump in your throat, sticky mucus that won’t go away, and you have to clear your throat before speaking. These two problems may seem different—one called reflux, the other often attributed to allergies or nervousness—but in many cases, they have the same cause: a malfunctioning sphincter.
The problem isn’t always excess acidity. Often, it’s actually a malfunction of the stomach valve. And here’s something that might seem strange: you can suffer from reflux without feeling any heartburn. If you’re looking for a quick fix, you might already have a quick remedy like baking soda to relieve the immediate symptoms. But using a quick fix every day doesn’t solve the problem at its source. Today, we’re leaving aside temporary solutions and focusing on the underlying issue. We’re going to delve deeper into the matter, and I’m going to show you how to strengthen this valve to prevent acid and gas reflux, allowing you to become less dependent on medication. (Based on the work of Dr. Alberto Sanagustín)
Key points to remember
The problem is mechanical: acid reflux is often caused by a weak lower esophageal sphincter (LES), the valve between your esophagus and stomach, and not just by excess acid.
Use gravity to your advantage: simple changes like sleeping on your left side, raising the head of your bed, and not lying down for 2 to 3 hours after eating can significantly reduce symptoms.
Avoid overfilling your stomach: apply the “80% fill” rule and avoid drinking large amounts of liquid during meals to prevent pressure from forcing the valve open.
Identify aggravating chemical factors: certain foods and substances such as mint, chocolate, alcohol, and tobacco can chemically relax the valve, thus worsening reflux. Temporarily eliminating them may promote the healing of your valve.
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1. It’s not just a simple pouch: understanding your stomach’s pressure system
To solve this problem, it’s essential to understand a fundamental concept: the stomach isn’t simply a pouch, but a reservoir with variable pressure. Imagine a balloon filled with liquid and gas. If you compress it, its contents will rise. What prevents this from happening between the stomach and the esophagus? A small, circular muscle located at the entrance, called the lower esophageal sphincter (LES). You can compare it to the knot in the balloon or a valve. The problem is that this sphincter can rupture for various reasons. It can open due to distension or pressure changes. Other times, it’s due to improper muscle relaxation. Finally, in some cases, a hiatal hernia weakens it structurally, allowing the contents to flow back up.
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This brings us to a common misconception I often see in comments: “Doctor, if I have reflux, should I suppress stomach acid?” The answer is no. Acid is vital. It kills bacteria, aids in protein digestion, and is essential for vitamin B12 absorption. The problem isn’t that acid is inherently bad; the problem is that it flows back up to the wrong place. It reaches your esophagus and throat. And why does this happen? Because the one-way valve is malfunctioning. While medications like omeprazole reduce this acid attack and can treat esophagitis, they don’t mechanically strengthen this valve. They don’t close the door. That’s why today we’re focusing on strengthening this valve from a mechanical perspective.
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